ADHD Meds: Impact on Training/Recovery

I’m curious what other medicated ADHDers have found with regard to mitigating the impact on training, and specifically on the ability to recover/sleep. In particular I’d love to hear from anyone who has tried Atomoxetine, which isn’t a traditional stimulant but a noradrenaline reuptake inhibitor.

I’m an adult diagnosis (37yo, and IDed the symptoms partly thanks to @Nate_Pearson’s continued openness to discussing on the podcast) so am just starting to figure out meds now. My psychiatrist started me on Atomoxetine rather than one of the amphetamines because it’s supposed to be less likely to exacerbate anxiety.

I think I started in the second week of December, and it’s just in the last week or so that I started to suspect it might be the reason I’ve been sleeping so poorly lately. I’m completely off of alcohol at the minute, but the best way I can describe the feeling is that it’s like all my sleep has been alcohol-induced so none of it is ever high enough quality to allow recovery from training. I’m getting through VO2 and Anaerobic workouts but I don’t think I’ve made it past the first interval set in an over/under workout since Christmas - exactly what I’d expect if I’m carrying too much fatigue and overdue for a recovery week. Recovery weeks seem to get me back on track for one workout and then I’m in the rut again.

I also don’t really notice any positive effects of the meds - maybe slightly clearer headed, but I’m certainly not able to get any more work done during the day or stay on task any better. So even though it’s another couple weeks before I check in with the doctor again, I decided to come off the meds for a bit. I’ve now skipped three days and it has felt like the three best nights of sleep in my life! In fact, I’m refreshed enough that I’m actually becoming more productive at work again. And workouts feel ‘right’ again. Tomorrow will be my next go at o/u, but I’m quietly confident of a better result.

I see a brief bit of discussion about sleep in this thread from a few years ago, but it’s mostly incidental to the main topic: Adhd, Medication, Training. Has Atomoxetine interfered with anyone else’s sleep? If I ask to switch to traditional stimulants should I expect the same again, or is it easier to come down from those? I see one mention in the other thread of avoiding extended-release amphetamines in order to be able to get to sleep - is that common with other folks too?

(I’m aware of WADA regs and know I’ll need to come off of everything entirely for a few days prior to any competition involving screening. I’m asking here specifically about training and recovery impact.)



Hello there Alex. Another ADHDer taking atomoxetine here. In my case it doesn’t affect sleeping, but might be also because I have another drug for helping with it. However, what I have noticed is that it severly affects my perfomance on the bike. My HR has increase an average of 20 bpm for the same power than before taking atomoxetine, especially noticeable at lower wattages. It helps a bit with anxiety and work, but not much, and it’s affecting the riding until the point that I’m considering stopping the medication since riding is really therapeutic for me.

How did it evolve in your case? Have you tried stopping it for some periods and coming back?

Thanks for chiming in Tumakero.

My HR was high too. In fact I saw a new all time max whlst on atomoxetine, as well as TrainingPeaks telling me I had new PRs for HR for all durations. I wouldn’t say 20 bpm in my case though, but that could be because I already have a really high natural HR so there may just have been less room to increase (new max was 208, old 207).

I never went back on atomoxetine after I made that post. In the following days I also realised the drug had made me really constipated and that I’d been experiencing a couple of other side effects to do with urinary and sexual sensation. I had a hernia repair at the end of September so was still recovering when I started the meds and had just assumed that the ‘down there’ changes were all related to the op. That is, until I stopped the meds and everything went back to normal.

At that point there was no way I was trying that one again and once I described it all to the Dr. he agreed. He did say I was on the starter dose though, so if I hadn’t been experiencing such negative side effects he would have wanted me to try a stronger dose before giving up and trying something else.

I’m now on the starter dose of a more traditional extended-release amphetamine (methylphenidate something). It affects my sleep for the first two or three nights I’m on it but then I seem to adapt (I’ve come off of it twice now for competition and had the same result when re-starting both times). That does make me worry that it’s still potentially affecting my sleep in ways I’m just not quite aware of, so at some point I’ll ask to try the standard release version and see what that’s like.

My HR is higher on current meds too but not in the same way. It doesn’t feel any different than normal, the numbers are just higher, and less extreme. On atomoxetine I constantly felt like I was on the edge of revving out and collapsing, even during mid-intensity intervals.

I probably also need to ask to up the dosage of the current stuff as I notice a benefit but I think could be getting more out of it. Next dose up is double my current one so one time I took two on a day I had loads of high-focus stuff on - seemed ok but since it was a unique situation I’ve nothing to compare against. I’ll have to try again in a more normal setting and see how I get on.

Hope you find your way with (or without) atomoxetine too. Talk to your doctor if it’s not right!

I never quite thanked you for your post, so a year later (hello ADHD and minor tasks) I do. After your experience I did talk to my doctor, changed meds and doing way better. It really is a process of adapting and the poor social level of understanding the disorder doesn’t help at all (at least in Spain), so being able to share it with people with similar issues is relieving. Thank you, Alex.

1 Like

Some of the sleep issues might be caused by the general change in routine brought about by the meds. You’re burning energy differently throughout the day for example. This medication is closer in nature to a SSRI, so maybe look over there for answers (it’s not an SSRI though).

EDIT: Supposedly Guanfacine is in this same space. (It maybe seen as a light version of the non-stimulants and prescribed along side a stimulant IIRC and read the room right). My kids tried this and all it did was make them moody and sleep poorly. Have a look. Guanfacine - Wikipedia

One issue I had was that I couldn’t pee. I’d have a full bladder but couldn’t release all the valves that allow you to pee. I can only describe it otherwise like trying to pee while swimming in a cold lake. When I did pee, it was like a 20min effort to drain the main vein. I had heard this might be a symptom, but don’t see it listed anywhere. I quit this after a week.

My advice/theories-
If you try the stimulants, try to get a non-generic time release one from the get go (or try & fail the non-time release/generic ones). The reason being “consistency of the meds”. The regular release ones tend to give you an inconsistent response throughout the day. The reason for name brand is that the time-release mechanisms they use are different for each mfg; the brand name will have a consistent time-release, while the generic will be less consistent refill to refill. After you figure out what works, then generic is fine- though some people don’t like specific generics.
-Keep in mind the meds can only do so much.
-On the stimulants, Ask the pharmacy what is consistently in stock. Try those first. Stopping the stimulants might see you pack on a pound or two while you adjust. If you’re middle aged or a competitive athlete, this will be an issue.

1 Like

I added a note above. Instead of looking at SSRI symptoms, look at Guanfacine for sleep issues. There’s parallels there in the meds and your symptoms.

Thanks for the suggestion but at this point I’ve already left atomoxetine for extended-release methylphenidate and subsequently switched to standard release to allow myself even more control over sleep side-effects and have been really happy.

I’m a freelancer with a creative job so there are some extra benefits to standard-release for me. Very often I only really need one dose and that’s plenty of time for me to get through all the bitty and admin-heavy parts of my day’s tasks, leaving me free to spend the other half of my work day in a bit more of a daydream-y and creative space.

Obviously it’s also not uncommon for me to intend to take a second dose and then realise too late in the afternoon that I’ve forgotten to do so and no longer have enough time left before bed for it to sufficiently clear out of my system. That’s my own fault though - at this point I’m sure all of us can easily come up with about a dozen different behaviour/routine modifications I could make to easily address that!

EDIT TO ADD USA DRUG NAMES FOR FUTURE FORUM SEARCHES: the journey described above was from Strattera to Vyvanse to Ritalin.

Only one that might be swayed slightly by being generic is the Vyvanse since someone pointed out that it’s the delay-release mechanism rather than the drug itself which is proprietary to a specific brand.

1 Like